Undiagnosed SARS-CoV-2 infection and outcome in patients with acute MI and no COVID-19 symptoms
Objective We aimed to determine the prevalence and outcome of occult infection with SARS-CoV-2 and influenza in patients presenting with myocardial infarction (MI) without COVID-19 symptoms.Methods We conducted an observational study from 28 June to 11 August 2020, enrolling patients admitted to the...
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doaj-06615ea45bbf414d9a493d559352c35c2021-07-28T18:01:03ZengBMJ Publishing GroupOpen Heart2053-36242021-06-018110.1136/openhrt-2021-001617Undiagnosed SARS-CoV-2 infection and outcome in patients with acute MI and no COVID-19 symptomsMustafizur Rahman0C Raina MacIntyre1Zubair Akhtar2Mohammad Abdul Aleem3Probir Kumar Ghosh4Mahmudur Rahman5Mohammad Enayet Hossain6Mariya Kibtiya Sumiya7A K M Monwarul Islam8Mir Jamal Uddin9Sara Cajander10Infectious Diseases Division, ICDDRB, Dhaka, Dhaka District, BangladeshBiosecurity Research Program, Kirby Institute, University of New South Wales, Sydney, New South Wales, AustraliaInfectious Diseases Division, ICDDRB, Dhaka, Dhaka District, BangladeshInfectious Diseases Division, ICDDRB, Dhaka, Dhaka District, BangladeshInfectious Diseases Division, ICDDRB, Dhaka, Dhaka District, BangladeshInfectious Diseases Division, ICDDRB, Dhaka, Dhaka District, BangladeshInfectious Diseases Division, ICDDRB, Dhaka, Dhaka District, BangladeshInfectious Diseases Division, ICDDRB, Dhaka, Dhaka District, BangladeshDepartment of Cardiology, National Institute of Cardiovascular Diseases Dhaka (NICVD), Dhaka, BangladeshDepartment of Cardiology, National Institute of Cardiovascular Diseases Dhaka (NICVD), Dhaka, BangladeshDepartment of Infectious Diseases, Orebro University, Orebro, SwedenObjective We aimed to determine the prevalence and outcome of occult infection with SARS-CoV-2 and influenza in patients presenting with myocardial infarction (MI) without COVID-19 symptoms.Methods We conducted an observational study from 28 June to 11 August 2020, enrolling patients admitted to the National Institute of Cardiovascular Disease Hospital, Dhaka, Bangladesh, with ST-segment elevation MI (STEMI) or non-ST-segment elevation MI who did not meet WHO criteria for suspected COVID-19. Samples were collected by nasopharyngeal swab to test for SARS-CoV-2 and influenza virus by real-time reverse transcriptase PCR. We followed up patients at 3 months (13 weeks) postadmission to record adverse cardiovascular outcomes: all-cause death, new MI, heart failure and new percutaneous coronary intervention or stent thrombosis. Survival analysis was performed using the Kaplan-Meier method.Results We enrolled 280 patients with MI, 79% male, mean age 54.5±11.8 years, 140 of whom were diagnosed with STEMI. We found 36 (13%) to be infected with SARS-CoV-2 and 1 with influenza. There was no significant difference between mortality rate observed among SARS-CoV-2 infected patients compared with non-infected (5 (14%) vs 26 (11%); p=0.564). A numerically shorter median time to a recurrent cardiovascular event was recorded among SARS-CoV-2 infected compared with non-infected patients (21 days, IQR: 8–46 vs 27 days, IQR: 7–44; p=0.378).Conclusion We found a substantial rate of occult SARS-CoV-2 infection in the studied cohort, suggesting SARS-CoV-2 may precipitate MI. Asymptomatic patients with COVID-19 admitted with MI may contribute to disease transmission and warrants widespread testing of hospital admissions.https://openheart.bmj.com/content/8/1/e001617.full |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Mustafizur Rahman C Raina MacIntyre Zubair Akhtar Mohammad Abdul Aleem Probir Kumar Ghosh Mahmudur Rahman Mohammad Enayet Hossain Mariya Kibtiya Sumiya A K M Monwarul Islam Mir Jamal Uddin Sara Cajander |
spellingShingle |
Mustafizur Rahman C Raina MacIntyre Zubair Akhtar Mohammad Abdul Aleem Probir Kumar Ghosh Mahmudur Rahman Mohammad Enayet Hossain Mariya Kibtiya Sumiya A K M Monwarul Islam Mir Jamal Uddin Sara Cajander Undiagnosed SARS-CoV-2 infection and outcome in patients with acute MI and no COVID-19 symptoms Open Heart |
author_facet |
Mustafizur Rahman C Raina MacIntyre Zubair Akhtar Mohammad Abdul Aleem Probir Kumar Ghosh Mahmudur Rahman Mohammad Enayet Hossain Mariya Kibtiya Sumiya A K M Monwarul Islam Mir Jamal Uddin Sara Cajander |
author_sort |
Mustafizur Rahman |
title |
Undiagnosed SARS-CoV-2 infection and outcome in patients with acute MI and no COVID-19 symptoms |
title_short |
Undiagnosed SARS-CoV-2 infection and outcome in patients with acute MI and no COVID-19 symptoms |
title_full |
Undiagnosed SARS-CoV-2 infection and outcome in patients with acute MI and no COVID-19 symptoms |
title_fullStr |
Undiagnosed SARS-CoV-2 infection and outcome in patients with acute MI and no COVID-19 symptoms |
title_full_unstemmed |
Undiagnosed SARS-CoV-2 infection and outcome in patients with acute MI and no COVID-19 symptoms |
title_sort |
undiagnosed sars-cov-2 infection and outcome in patients with acute mi and no covid-19 symptoms |
publisher |
BMJ Publishing Group |
series |
Open Heart |
issn |
2053-3624 |
publishDate |
2021-06-01 |
description |
Objective We aimed to determine the prevalence and outcome of occult infection with SARS-CoV-2 and influenza in patients presenting with myocardial infarction (MI) without COVID-19 symptoms.Methods We conducted an observational study from 28 June to 11 August 2020, enrolling patients admitted to the National Institute of Cardiovascular Disease Hospital, Dhaka, Bangladesh, with ST-segment elevation MI (STEMI) or non-ST-segment elevation MI who did not meet WHO criteria for suspected COVID-19. Samples were collected by nasopharyngeal swab to test for SARS-CoV-2 and influenza virus by real-time reverse transcriptase PCR. We followed up patients at 3 months (13 weeks) postadmission to record adverse cardiovascular outcomes: all-cause death, new MI, heart failure and new percutaneous coronary intervention or stent thrombosis. Survival analysis was performed using the Kaplan-Meier method.Results We enrolled 280 patients with MI, 79% male, mean age 54.5±11.8 years, 140 of whom were diagnosed with STEMI. We found 36 (13%) to be infected with SARS-CoV-2 and 1 with influenza. There was no significant difference between mortality rate observed among SARS-CoV-2 infected patients compared with non-infected (5 (14%) vs 26 (11%); p=0.564). A numerically shorter median time to a recurrent cardiovascular event was recorded among SARS-CoV-2 infected compared with non-infected patients (21 days, IQR: 8–46 vs 27 days, IQR: 7–44; p=0.378).Conclusion We found a substantial rate of occult SARS-CoV-2 infection in the studied cohort, suggesting SARS-CoV-2 may precipitate MI. Asymptomatic patients with COVID-19 admitted with MI may contribute to disease transmission and warrants widespread testing of hospital admissions. |
url |
https://openheart.bmj.com/content/8/1/e001617.full |
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